Brown... No to Mandatory Organ Donation Plan

Britons must 'opt in' to become an organ donor - unlike in Spain where there is 'presumed consent'... Gordon Brown has refused to rule out a change in the law that may see everyone considered as a potential organ donor, despite the recommendations of his advisers yesterday.

The opt-out system of organ donation should not be introduced as it could undermine patients' confidence in medical care, the UK Organ Donation Taskforce said.

The system of "presumed consent", as used in Spain and other countries, was unlikely to boost donation rates, as The Times revealed on Friday.

A £4.5 million public awareness campaign in England will start next year with the aim of boosting the number of people on the voluntary organ donation register.

But the Government said that if measures to improve the current system did not work within five years, a law change in the law may follow.

However, Mr Brown is understood to favour a system of "soft" presumed consent, where relatives would be able to object and stop organs being harvested if they found the idea too painful.

He said yesterday that if the campaign failed to have the necessary impact, the laws on consent may change. "I'm not ruling out a further change in the law. We will revisit this when we find out how successful the next stage of the campaign has been," he said.

There are currently around 8,000 people in the UK who need an organ transplant but only 3,000 operations are carried out each year. About 1,000 people a year die while waiting for a transplant.

But the taskforce said that while the public and the major religious groups in the UK supported the principle of organ donation, there were myths and confusion surrounding how it worked in practice.

Adopting a law where most people could be automatically considered to be donors would undermine the idea of donation as a personal choice and make people worry about doctors' intentions in caring for their loved ones, it said.

The issue has divided doctors and patients groups, but faith leaders told the committee that changing consent laws may cause a backlash among the public and even decrease rates of available organs.

Elizabeth Buggins, chair of the taskforce, said that the issue raised "really strong emotions", and that the group's decision had been delicately balanced.

She said: "We found from recipient families and donor families that the concept of gift was very important to them and presumed consent would undermine that concept.

"We also found that it has the potential to erode trust in doctors, and we know that is very important to the levels of donation.

"There is lots of fear out there that organs are taken from patients before they are dead - that is absolutely not true."

Currently, people must sign up to the organ donor register, or their families must agree, before their organs can be used.

Alan Johnson, the Health Secretary, announced that the public education campaign was aimed at signing up 20 million people to the organ donor register by 2010, and 25 million by 2013. A similar campaign has already has some success in Scotland.

The taskforce, made up of doctors, lawyers and ethicists among other professionals, gathered more than 400 pages of evidence from across the world and held consultation events with the public and religious groups on the issues surrounding presumed consent.

It found that, while many countries with high donor rates had presumed consent laws, there was little evidence to show that the effect was causal.

Ms Buggins said that although a system of presumed consent in Spain had been followed by a rise in organ donation, the rise was not thought to be down to the switch.

Instead, Ms Buggins said, a rise in organ donations was more likely to be achieved by increasing in the number of donor co-ordinators who work with bereaved families, and the number of specialists who retrieve organs, and by launching public information campaigns.

Vivienne Nathanson, chair of ethics at the British Medical Association, said she was disappointed by the task force's findings.

She said presumed consent was not a panacea, but was likely to result in a 10 to 15 per cent increase in donated organs, if sufficient surgeons, intensive care beds and transplant coordinators were put in place.

She said it would also encourage families to discuss their views, and make their wishes clear before death: "We know that the majority of the population want to be organ donors, but only 25 per cent are on the register.

"Turning it round the other way, so that you take organs from everyone unless they have either put their name on a register to opt out, or their family say they wanted to, but haven't got round to it, means you could quite significantly increase the numbers of donors."

However, Tim Statham of the National Kidney Federation said organs were being wasted because of a lack of capacity in the NHS, a situation which presumed consent would not solve.

Professor John Fabre, a former president of the British Transplantation Society, said presumed consent was a simplistic way to try to boost organ donation rates, which would be a waste of time.

The latest recommendations on presumed consent are not binding and the Government could decide to press ahead with changes to the legislation.

Any change to the system would involve amending the Human Tissue Act of 2004.

Health ministers in Scotland and Wales have suggested they are sympathetic to arguments in favour of presumed consent.

Joyce Robins, co-director of the campaign group Patient Concern, said: "We can only hope that Gordon Brown does not follow the example of the Welsh Health Minister. Edwina Hart, who rejected the all-party Welsh Assembly report when they decided against presumed consent after weeks of evidence and is still pressing ahead."

"What difference does it make to the dead, the orphans, and the homeless, whether the mad destruction is brought under the name of totalitarianism or the holy name of liberty and democracy?" - - - Mahatma Ghandi

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